1. Working together : a provider’s perspective on commissioning Maria S. Parsons Dementia Lead for Sanctuary Care

2. Where are we? Significant commissioning agenda, especially for PCTs, in the context of targets for heath, personalisation and other policy change Complex needs of people with dementia Need to commission services across whole trajectory of dementia ( from prevention to end of life care) Market anticipating increasing demand BUT cautious given economic downturn

3. Sanctuary Care Part of Sanctuary Care, UK’s largest housing association: social housing,market rented and care 52 care homes for older people, adults with learning disabilities, physical disabilities and those with mental health difficulties 12 Extra Care schemes 3 Home care services in south west England

4. Supporting people with dementia Majority of service users across 33 care homes, Extra Care and Home Care services have a dementia Like other providers we are shifting services to focus on specialist dementia services We have limited block contracts and are geared to private purchasers ( hence not as vulnerable as some providers reliant on publicly funded care) Looking at new service developments in the wake of the National Dementia Strategy: younger people with dementia, ARBD and older people with learning disabilities

5. These things help providers LA/Health Trusts sharing commissioning intentions Transparent tendering and contracting processes Working together on contract compliance and continuous improvements in quality and outcome Long term contracts and risk sharing as part of strategic partnership Joint development of skilled workforce

6. Effective commissioners….. Recognise the costs of individuals with dementia - complex and changing needs Make allowance for inflation; recognise the real cost of delivering a high quality service Negotiate prices fairly and don’t simply drive fees down Trust our financial motivation and activities

7. We can help you by sharing….. Local needs profiles, demand trends and other information that we routinely collect to make business decisions Data on good outcomes for users of our services Our strategic direction of travel and ideas for improved models of care Results of our research and development about what works Design and building development expertise

8. Things we like to hear….. ‘We will be looking for more extra care’ rather than ‘we won’t be buying so much residential care in future’ ‘We are going to work with you on kite marking system for local homes’ ‘We envisage a need for an additional 3 Intermediate Care beds for people with dementia in 3 months time ‘We would like to offer your staff free training’

9. Partnership working Working with local councils and PCTs where we have a critical mass of resources ( home care, extra care and care homes) that can be used flexibly to deliver on service improvement Oxfordshire: Nursing dementia and Intermediate care with Oxfordshire Social and Health care and PCT/MHT + 2 new care homes planned Redbridge – progressing residential and nursing home care and plans for Care Village

10. Personalisation..providers perspective …. The challenge of managing operations whilst responding to personalisation agenda, Individual Budgets and Personal Budgets Shift in balance of risk in places where providers have large block contracts Need to transmit information to personal budget holders about real costs of our services Gaps in local brokerage might offer potential for joint work

11. The future together Developing new models of service – flexible home care and telecare with a base in care homes to promote enablement/reablement Premium for quality in volume market Incentivise and share risks Make decisions in good time Trust, transparency and accountability

12. Thank you and contact Maria Parsons Dementia Lead Sanctuary Care Maria.Parsons@sanctuary-housing.co.uk Mobile 07554 115681